Notice of Voluntary Withdrawal

This is to inform you that I wish to withdraw from the Section 8 Housing choice voucher   program.  I understand that by completing this form, I am requesting that the Seminole County Housing Authority stop making Housing Assistance Payments (HAP) to my landlord. 

Please make my withdrawal date effective______________________________.

Head of household ________________________________________________________

Address ___________________________________________ Apt. No.______________

City _____________________________________ State _________ Zip _____________

       Telephone # ____________________________________________

      ________________________________________________________________

         Signature of Head of Household

      ______________________________

         Date